Using a diamond knife, set at 90% of corneal thickness at (90 degrees meridian), at 8 mm optic zone, a radial incision was done and corneal pockets were created. A 6.0 nylon preloaded spatula was then inserted into the corneal pocket and in a counterclockwise direction rotated in 3600 to create a deep stromal tunnel
Basic overview of phaco dynamics along with all the Newer phacoemulsification techniques available in current practice - a video-assisted the presentation
PRK ..... Is it a good alternative to lasik ????Amr Mounir
This presentation try to answer the recent debatable question about which is better LASIK or PRK , when to choose each of them and how to exclude complications of both procedures.
Basic overview of phaco dynamics along with all the Newer phacoemulsification techniques available in current practice - a video-assisted the presentation
PRK ..... Is it a good alternative to lasik ????Amr Mounir
This presentation try to answer the recent debatable question about which is better LASIK or PRK , when to choose each of them and how to exclude complications of both procedures.
Minimally Invasive Glaucoma Surgery (MIGS)Meironi Waimir
Minimally invasive glaucoma surgery (MIGS) is a group of procedures that minimizes the invasive rate of glaucoma with five characteristics: ab interno microincision, minimal trauma, more effective, high safety profile, and quick recovery.
MIGS is a surgery that uses an incision in a clear cornea and is indicated in patients with mild to moderate open angle glaucoma.
The technique of MIGS is based on several mechanisms, namely trabecular meshwork bypass stents including iStent, trabectome, and Hydrus microstent; Suprachoroidal implant using Cypass microstent; And subconjungtiva filtration using XEN gel stent.
MIGS technology has potential advantages in glaucoma management by reducing the burden of treatment, improving patients quality of life, and cutting or delaying more invasive surgeries.
Indication, contraindication, advantage, disadvantage, types of keratoplasty, complication of keratoplasty and management, corneal graft rejection and failure
M.S ophthalmology, sarojini devi eye hospital, regional institute of ophthalmology, osmania medical college, hyderabad, telangana
Minimally Invasive Glaucoma Surgery (MIGS)Meironi Waimir
Minimally invasive glaucoma surgery (MIGS) is a group of procedures that minimizes the invasive rate of glaucoma with five characteristics: ab interno microincision, minimal trauma, more effective, high safety profile, and quick recovery.
MIGS is a surgery that uses an incision in a clear cornea and is indicated in patients with mild to moderate open angle glaucoma.
The technique of MIGS is based on several mechanisms, namely trabecular meshwork bypass stents including iStent, trabectome, and Hydrus microstent; Suprachoroidal implant using Cypass microstent; And subconjungtiva filtration using XEN gel stent.
MIGS technology has potential advantages in glaucoma management by reducing the burden of treatment, improving patients quality of life, and cutting or delaying more invasive surgeries.
Indication, contraindication, advantage, disadvantage, types of keratoplasty, complication of keratoplasty and management, corneal graft rejection and failure
M.S ophthalmology, sarojini devi eye hospital, regional institute of ophthalmology, osmania medical college, hyderabad, telangana
Dr. Guilherme Rocha, Dr. Paulo Ferrara, Dr. Leonardo Torquetti, Dra. Luciene Barbosa analisam os resultados dos implantes de Anel de Ferrara de Arco longo no pós operatório de 6 meses
Title: Otoplasty: New Modification of the Mustardé technique
Author: Mohamed A.S.M. El-Rouby, MD,
Assistant Professor of Plastic surgery, Ain Shams University, Cairo, Egypt.
Abstract
Background: one of the most established techniques for management of protruding ears is the Mustardé technique (1). Many modifications had been published for this technique; however, all these modifications started by retro-auricular incision. We modify the Mustardé technique using three retroauricular microincisions to correct several deformities of the auricular cartilage in protruding ears.
Patients and Methods: 46 patients (7unilateral, 39 bilateral) (85 ears) who were candidates for this technique, their age (25 ± 2.8 years), 38 males, 8 females. The operation time, steps, follow up sessions (2 weeks, 3, 6 and 18 months) data was recorded. Preoperative and postoperative (1,18 months) photos were compared and analyzed by custom made computer program the evaluated the results.
Results: 42 patients achieve a natural appearance. extrusion of threads occurred in 8 ears. Asymmetrical ears were noticed in 4 patients and recurrence in 11 patients. These patients were revised by Mustardé technique with retro-auricular incisions. None of the patients developed retro-auricular scars.
Conclusion: this versatile modification allows for better asthenic results of otoplasty and minimizes complications of skin incision unless cartilage and/or skin resection is needed.
PURPOSE: To report the clinical outcomes of implantation of a new Ferrara intrastromal corneal ring segment (ICRS) with a 210-degree arc length in eyes with keratoconus.
Double Rings - New approachs to fine tune clinical outcomes.pdfFerrara Ophthalmics
Inimaginável há poucos anos, a associação de segmentos concêntricos adjuvantes no tratamento da miopia e ceratocone tem trazido resultados praticamente refrativo no tratamento de pacientes com alta miopia e astigmatismo. A associação de segmentos de 5mm e 6mm se faz possível pela alta qualidade e precisão dos Tomógrafos e Laser de Femtosegundo que tornam a cirurgia extremamente precisa e os resultados reprodutíveis e passíveis de reintervenção e adequação do planejamento inicial.
Confira a apresentação competa com as indicações, citação do artigo científico, os resultados do estudo clinico inicial com 42 olhos, os resultados, a técnica cirúrgica e o nomograma do Ferrara HM para pacientes com miopia moderada a alta e contraindicação a cirurgia de PRK por limitação de espessura corneana.
Na edição 1991 do terceiro trimestre de 2021 a Revisa Oftalmologia em Foco destacou em sua capa o Surgimento de um Novo Anel intra corneano com foco nos pacientes com miopia moderada a alta com contra indicação ao PRK por limitação da espessura da córnea
Estudo de Casos Clínicos do Implante de Anel de Ferrara para o tratamento do Ceratocone disponibilizado pela Dra. Jordana Sandes para Drylab da Ferrara Ophthalmics no Curso refrativa RIO 2022
Resultados preliminares do implante de um novo anel associado ao PRK para pre...Ferrara Ophthalmics
Dr. Sandro Coscarelli, Dr. Pablo Rodrigues, Dr. Guilherme Rocha e Dr. Leonardo Torquetti compilaram e compartilham seus resultados com o uso de Segmentos de Anel de Ferrara HM associado ao PRK para a correção da miopia de pacientes com corneas finas e contra indicados para as técnicas de Excimer Laser apenas.
A multicentric nonrandomized study was conducted in which a new 320-ICRS was placed in 138 eyes of 130 patients with keratoconus. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, corneal volume, asphericity, lines of vision gain/loss, and vectorial analysis were assessed preoperatively and at the final follow-up visit after the procedure.
Estudos do comportamento da luz e de sua refração no prisma demonstram como o filtro amarelo atua minimizando a formação de halos e glare no corpo dos segmentos de Anel de Ferrara™.
O intuito do filtro é minimizar qualquer desconforto que a presença do ICRS - Intra Corneal Ring Segments - possam causar ao paciente.
Esta tecnologia é exclusiva da Ferrara Ophthalmics e utilizada em 87 países.
Desde sua patente em 1987, o Anel de Ferrara e a técnica de implante vêm se aprimorando. Hoje, com indicações seguras e reprodutíveis a técnica é realizada em 87 países e mais de 600.000 olhos já forma implantados.
Excepcional artigo produzido pela Dra. Jordana Sandes do CEROF, GO mostra os efeitos dos arcos de 140º em Ceratocones com valores de astigmatismo elevados.
Avaliação das alterações na curvatura anterior e posterior da Córnea, sua paquimetria, resultados visuais e refrativos após o Implante de Anel de Ferrara com o auxilio do Galilei.
Acompanhe este resumo do Implante de Anel de Ferrara para correção do Ceratocone. Característica, Mecanismo de Ação, técnica Cirúrgica, os diferentes arcos e efeitos são alguns dos tópicos abordados
A Aula apresenta os conceitos básicos sobre implantes intra corneanos, a evolução do nomograma da Ferrara Ophthalmics, a classificação morfologia do aspecto coreano e alguns casos clínicos.
Autor: Dr. Guilherme Rocha
Indicações de nomograma de utilização de segmentos de 320º de arco a partir de analise estatística de 26 casos operados e correlação com diferentes arcos existentes.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
2. NEW TECHNIQUE OF DEEP ANTERIOR LAMELLAR KERATOPLASTY80
JOURNAL OF EMMETROPIA - VOL 2, APRIL-JUNE
Figure 1A.
Figure 1D.
Figure 1E. Figure 1F.
Figure 1B.
Figure 1C.
3. ula was removed from the tunnel and the nylon wire
was pulled from both sides of the radial incision to dis-
sect deep to corneal stroma leaving only the Descemet’s
membrane (fig. 1G, 1H and 1I). A partial-thickness
8.0 mm trephination was done. The trephine was used
to cut until it touches the spatula beneath the corneal
stromal tunnel (fig. 1J). Blunt-tipped Vannas scissors
were used to remove anterior stromal tissue along the
edge of partial thickness trephination (fig. 1L).
The donor cornea was punched out from the
endothelial side, oversized by 0.5 mm, comparing to
recipient trephination. The donor button was sutured
into place using a continuous or 16 interrupted 10-0
nylon sutures (fig. 1M and 1N), without removal of
donor endothelium and Descemet’s membrane.
Postoperative medication included Moxifloxacin
and Prednisolone four times a day for a week and
tapered for a period of 6 weeks. Lubricants were used
several times a day. The sutures were removed 3
months after the surgery (fig. 2).
NEW TECHNIQUE OF DEEP ANTERIOR LAMELLAR KERATOPLASTY 81
JOURNAL OF EMMETROPIA - VOL 2, APRIL-JUNE
Figure 1G. Figure 1H.
Figure 1L.
Figure 1I.
Figure 1J.
4. DISCUSSION
Several techniques of lamellar keratoplasty have
been described for keratoconus treatment. Anwar and
Teichmann described the big-bubble technique to
achieve separation of the Descemet´s membrane from
stroma after intrastromal air injection6. This technique
has been widely used as a technique which provides
rapid and satisfactory outcome that is comparable to
PK2. The technique allows a safe and direct access to
Descemet’s plane, with the advantages of shortening
the surgical time, reducing the risk for perforation, and
exposing a smooth, even surface of excellent optical
quality. However, a big bubble is not formed in all
cases6,11 and sometimes more than one injection of air
into the deep stroma is required before cleavage
between Descemet’s membrane and the stroma is
achieved. In these cases, repeated injections of air infil-
trating the corneal stroma may cause complete whiten-
ing of the central cornea within the area of trephina-
tion, making it difficult to recognize the line of separa-
tion between Descemet’s membrane and the stroma.
The increased safety of DALK and the potential for
better visual outcomes in expertly performed proce-
dures justifies the effort required for corneal surgeons
to master the procedure and the additional operating
room time. Another potential advantage is the utility of
using tissue that is less optimal for PKP with lower
endothelial cell counts or longer duration of death to
preservation and time in preservation to expand the
donor pool for optical keratoplasty.
The presented new technique of DALK eliminates
any potential difficulties in recognizing formation of
the big bubble during the surgery, which used to be the
main challenge in the most widely used technique
nowadays (big-bubble). Moreover, this new technique
has a shorter learning curve for the surgeon, which is
important as it can be a reliable technique when com-
pared to other DALK techniques or even the PK.
REFERENCES
1. Krumeich JH, Knülle A, Krumeich BM. Deep anterior lamel-
lar (DALK) vs. penetrating keratoplasty (PKP): a clinical and
statistical analysis. Klin Monbl Augenheilkd. 2008 Jul; 225:
637-648.
2. Javadi MA, Feizi S, Yazdani S, Mirbabaee F. Deep Anterior
Lamellar Keratoplasty Versus Penetrating Keratoplasty for
Keratoconus: A Clinical Trial. Cornea. 2010 Feb 17.
3. Jones MN, Armitage WJ, Ayliffe W, Larkin DF, Kaye SB;
NHSBT Ocular Tissue Advisory Group and Contributing
Ophthalmologists (OTAG Audit Study 5). Penetrating and
deep anterior lamellar keratoplasty for keratoconus: a compar-
ison of graft outcomes in the United kingdom. Invest
Ophthalmol Vis Sci. 2009 Dec; 50: 5625-5629.
4. Han DC, Mehta JS, Por YM, Htoon HM, Tan
DT.Comparison of outcomes of lamellar keratoplasty and
penetrating keratoplasty in keratoconus. Am J Ophthalmol.
2009 Nov; 148: 744-751.e1.
NEW TECHNIQUE OF DEEP ANTERIOR LAMELLAR KERATOPLASTY82
JOURNAL OF EMMETROPIA - VOL 2, APRIL-JUNE
Figure 1M. Figure 1N.
Figure 2.
5. 5. Malbran E. Lamellar keratoplasty in keratoconus. Int
Ophthalmol Clin 1966; 6: 99-109.
6. Anwar M, Teichmann KD. Big-bubble technique to bare
Descemet´s membrane in anterior lamellar keratoplasty. J
Cataract Refract Surg 2002; 28: 398-403.
7. Chamberlain W, Cabezas M. Femtosecond-assisted deep ante-
rior lamellar keratoplasty using big-bubble technique in a
cornea with 16 radial keratotomy incisions. Cornea. 2011 Feb;
30: 233-6.
8. Buzzonetti L, Laborante A, Petrocelli G. Standardized big-
bubble technique in deep anterior lamellar keratoplasty assist-
ed by the femtosecond laser.J Cataract Refract Surg. 2010 Oct;
36(10): 1631-6.
9. Colin J, Cochener B, Savary G, et al. Correcting keratoconus
with intracorneal rings. J Cataract Refract Surg. 2000; 26:
1117-1122.
10. Siganos D, Ferrara P, Chatzinikolas K, et al. Ferrara intrastro-
mal corneal rings for the correction of keratoconus. J Cataract
Refract Surg 2002; 28: 1947-1951.
11. Fogla R, Padmanabhan P. Results of deep lamellar keratoplas-
ty using the big bubble technique in patients with kerato-
conus. Am J Ophthalmol 2006; 141: 254-259.
NEW TECHNIQUE OF DEEP ANTERIOR LAMELLAR KERATOPLASTY 83
JOURNAL OF EMMETROPIA - VOL 2, APRIL-JUNE
First author:
Paulo Ferrara, MD, PhD
Paulo Ferrara Eye Clinic,
Brasil